Carotid-jugular fistula is a rare presentation of arteriovenous fistula. A case of a 60-year-old Chinese man who presented with iatrogenic carotid-jugular fistula with multiple fistulous points was reported. His presenting complaint was a gradually enlarging right pulsatile neck mass complicated by worsening symptoms of congestive cardiac failure. He had recent mitral valve annuloplasty, and a right internal jugular central venous pressure monitor insertion was performed then. Angiography revealed right carotid-jugular fistula with feeders from the external carotid, internal carotid and right vertebral arteries, all draining into the right internal jugular vein. He underwent embolisation twice resulting in transient improvement in clinical symptoms, and surgical resection was later performed in view of residual arteriovenous shunting and gradual clinical deterioration. Following surgery, he was discharged and resumed work as a janitor with no recurrent symptoms for 3 years now. In this report to be added into the literature, we discuss a rare case of iatrogenic carotid-jugular fistula with multiple fistulous points which required embolisation and subsequently surgical resection.
Hemangiopericytoma (HPC) has been described to be aggressive and potentially a malignant tumour. We report a rare case of a 63-year-old Chinese male who presented with primary intradural extramedullary HPC of the thoracic spine. The main presenting complaint was gradual progression of back pain, associated with paraparesis and sensory deficit of lower limbs. He had MRI thoracolumbar with contrast which showed T9 lesion compressing on spinal cord and oedema, he was then operated upon and histopathology report confirmed a thoracic spine HPC. A T8/9 laminectomy and excision of intradural extramedullary lesion was performed, tumour section was sent for frozen section study, and more tissue was sent for paraffin studies and additional immunohistochemical staining. Surgical resection is most commonly performed, radiotherapy remains debatable. In this report, we discussed another rare case of primary spinal HPC to be added into the literature.
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